Ottawa pediatrician’s research could transform outlook for premature babies

Elizabeth Payne, OTTAWA CITIZEN04.15.2014

Stephanie and Ata Iemsisanith snuggle with their baby girls, Mackenzie, left, and Mackayla, now four months old, at Children’s Hospital of Eastern Ontario. The twins were born three months’ premature.Julie Oliver
/ Ottawa Citizen

Dr. Bernard Thebaud, a pediatrician at CHEO, has published a paper demonstrating his findings that damaged lungs of premature infants can be safely repaired using stem cells and regenerative medicine.Julie Oliver
/ Ottawa Citizen

Twins, Mackayla, left, and Mackenzie cuddle after months of being treated apart at CHEO. The twins were born three months’ premature.Julie Oliver
/ Ottawa Citizen

OTTAWA — Parenthood began earlier than Stephanie and Ata Iemsisanith were expecting when their tiny twin daughters were born last December, three months ahead of schedule at less than 27 weeks’ gestation.

The smallest of the girls was so tiny, says Ata, cuddling his now-seven pound daughter, that he could cradle her in the palm of his hand.

Doctors gave Stephanie steroid shots before the birth to help mature the babies’ lungs. Once the girls were born — Mackayla, weighing about two-and-a-quarter pounds, and Mackenzie weighing just one-and-a-half pounds — doctors administered surfactant, the substance that coats the inside of lungs and is essential for the exchange of oxygen and carbon dioxide between the lungs and the blood.

Despite those treatments — both of which represented leaps forward in the survival and health of premature infants when they came into common use decades ago — the babies’ lungs will suffer some effects of their early births. They, like most premature infants, will have some level of chronic lung disease, known as bronchopulmonary dysplasia, that can have long-term effects, a result of prematurity and damage from ventilation and oxygen.

The fragility of their new babies’ lungs is something Mackayla and Mackenzie’s parents will have to keep in mind when they finally have them both at home. Mackayla, who now weighs almost 11 pounds, became the first to leave the CHEO neonatal intensive care unit and head to the family’s home in Kanata on Monday.

The focus on lung problems could eventually change for babies like Mackayla and Mackenzie, thanks to groundbreaking research being led by Dr. Bernard Thébaud, a senior scientist in regenerative medicine at the Ottawa Hospital Research Institute and the CHEO Research Institute.

Thébaud, who is a pediatrician at the Children’s Hospital of Eastern Ontario and The Ottawa Hospital and teaches at the University of Ottawa, published a paper in the medical journal Circulation this month demonstrating his findings that damaged lungs of premature infants can be safely repaired using stem cells and regenerative medicine. The research, the result of a five-year study conducted by Thébaud’s lab, represents the first such use of vascular progenitor cells (stem cells that make blood vessels).

The work, says Thébaud, has huge implications not only for treatment of lung disease in premature infants but for regenerative treatment of chronic lung disease such as emphysema in adults as well.

Thébaud’s findings, so far, are the result of research on lab animals. But his lab is hoping to begin further work soon that could lead to clinical trials in the next three years. Such research is notoriously slow to make it from the lab into practice — Thébaud notes that it took 30 years to get the use of surfactant from the lab stage into clinical use, whereas it took just eight years from announcement for the U.S. to put a man on the moon. But he is optimistic that regenerative stem cells can transform the outlook for premature babies by the end of this decade.

There are numerous potential implications of the findings, he says, not only for fragile preemies’ lungs, but potentially for the regeneration of other organs and the treatment of numerous lung diseases.

“The results are very promising. We think we have a breakthrough in the making.”

Lung damage continues to be a serious concern in premature infants because, even as new treatment have come along to help protect and mature their lungs, such medical breakthroughs have allowed ever younger babies to survive. In Canada, babies born at 23 or 24 weeks’ gestation now can be resuscitated and survive, depending on complications. At some hospitals in the U.S., premature infants as young as 21 weeks’ gestation survive. Along with those ever-younger births, come more lung complications.

Thébaud said there is limited research on what effect prematurity has on lungs later in life or whether compromised lung development can lead to early onset emphysema, for example, or high blood pressure.

Thébaud’s research on lab rodents transformed lungs similar to those of premature infants — which can look, he said, almost like smokers’ lungs — to fully functioning healthy lungs as a result of the stem cell therapy.

Such as breakthrough could mean one less challenge for families such as the Iemsisaniths, whose babies have had numerous challenges since birth and are now preparing for life in the outside world.

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Ottawa pediatrician’s research could transform outlook for premature babies

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